Cognitive-Behavioral Approaches To – Exam Questions | Ch6

CHAPTER 6: COGNITIVE-BEHAVIORAL APPROACHES TO COUNSELING IN SCHOOLS

Multiple Choice

1. Behavioral approaches were originally based on:

1. children
2. adults
3. animals
4. adolescents

2. Children are ________ reliant on their environments when compared to adults.

1. equally
2. somewhat less
3. less
4. more

3. If parents are working with the counselor to determine the nature of the concern, they might be considered:

1. colleagues
2. collaborators
3. co-clients
4. consultants

4. At times, parents may be unknowingly contributing to the concern. In these instances, they might be considered:

1. colleagues
2. collaborators
3. co-clients
4. consultants

5. Behavioral intervention includes the use of all but what:

1. positive reinforcement
2. extinction
3. the empty chair
4. shaping

6. At times CBT-oriented helpers enlist the help of families in implementing an intervention with a child, especially younger children. In these instances, parents would be viewed as:

1. colleagues
2. collaborators
3. co-clients
4. consultants

7. Cognitive-behavioral therapy is directed toward four systems of response. These systems include all but which:

1. behavioral
2. affective
3. cognitive
4. spiritual

8. The goal of this is to help an individual manage or control the physiological response that might accompany anxiety or high levels of arousal:

1. affective education
2. relaxation training
3. role playing
4. problem solving

9. When a helper is using their knowledge and experience to identify concerns they are acting as a(n):

1. diagnostician
2. consultant
3. collaborator
4. educator

10. If students have an irrational belief system, they may view themselves as:

1. inferior
2. lovable
3. superior
4. enchanting

11. When a helper considers the strategies that will best help a student learn new thoughts and behaviors they are acting as a(n):

1. diagnostician
2. consultant
3. collaborator
4. educator

12. “I am stupid and incapable” is an example of:

1. inclusion
2. catastrophizing
3. an inability to tolerate frustration
4. global ratings and labels placed on oneself

13. Much of the early research on CBT has been conducted in:

1. clinical settings
2. school settings
3. hospital settings
4. residential settings

14. A pattern of erroneous or exaggerated thinking is referred to by the umbrella term:

1. internalizing
2. cognitive distortions
3. global ratings
4. catastrophizing

15. “I simply cannot stand it anymore” is an example of:

1. global ratings
2. catastrophizing
3. an inability to tolerate frustration
4. labels placed on oneself

16. “It will be the worst thing ever if I’m not invited to this party” is an example of:

1. global ratings
2. catastrophizing
3. an inability to tolerate frustration
4. labels placed on oneself

17. Irrational thoughts are usually identified by the inclusion of the word:

1. will
2. possibly
3. should
4. may

18. Who developed Rational Emotive Behavioral Therapy?

1. Bandura
2. Ellis
3. Glasser
4. Freud

19. What is defined as an “organized set of beliefs, attitudes, memories and expectations, along with a set of strategies for using this body of knowledge in an adaptive manner”.

1. behaviors
2. automatic thoughts
3. automatic feelings
4. cognitions

20. According to Dobson and Dozois, the three fundamental propositions of cognitive-behavioral therapy include all but what:

1. Cognitive activity affects behavior
2. Cognitive activity may be monitored and altered
3. Desired behavior change may be effected through cognitive change
4. Feelings affect cognitive activity

21. Avoidance of social situations is an example of a(n):

1. attitude
2. automatic thought
3. behavior
4. belief

22. “If everyone doesn’t like and accept me, I’m not worthwhile” is an example of a(n):

1. attitude
2. automatic thought
3. behavior
4. belief

23. “No one likes me. They all think I’m a loser” is an example of a(n):

1. attitude
2. automatic thought
3. behavior
4. belief

24. Cognitive-behavioral interventions represent an integration of all but what:

1. behavioral approaches
2. self- regulation research
3. cognitive therapies
4. reality therapies

25. Cognitive theorists first introduced their models of therapy and began integrating behavioral techniques into their approach in the:

1. early 1930s
2. early 1940s
3. early 1960s
4. early 1970s

True/False

1. With the heightened emphasis on evidence-based practices, cognitive-behavioral therapy has become an approach that is frequently used in the schools.

2. Behavior is not mediated by one’s internal thoughts.

3. From a cognitive perspective, the observable actions of the individual are the most important component of change.

4. Treatment components of CBT may be introduced using workbooks, stories, puppets, drawings, and other types of hands-on activities

5. Current research suggests that CBT delivered in a school setting yields similar outcomes to delivery in clinical contexts.

6. Because of the central nature of behaviors, change in behavior is viewed as a precursor to cognitive change.

7. One of the important roles of cognitive-based interventions is to help student clients to learn how to identify and express emotions appropriately.

8. Cognitive-behavioral interventions focus on understanding how individuals interpret their experiences and the effects of these interpretations on their emotional and behavioral functioning.

9. There is no need for school-based professionals to develop therapeutic relationships with their student clients if they are using a very structured cognitive-behavioral intervention.

10. School-based professionals working from a CBT model must attend to both the internal and external factors that affect student clients.

Short Answer Essay

1. Discuss the role of school based helpers who adopt a CBT orientation.

• School-based helpers who adopt a CBT orientation, have been described as coaches who act as consultant/collaborators, diagnosticians, and educators.
• As a “consultant/collaborator,” the helper adopts the stance of one who does not have all the answers. Rather, a school-based helper presents ideas about things to try and creates opportunities for the student client to do so. Together, the helper and student use a problem-solving model to determine the best approach to reaching the student’s goals.
• Kendall also described helpers as diagnosticians because they used their knowledge and experience to identify concerns. Sometimes children are referred to school-based helpers with a vague description such as, “This student seems depressed” or “I can’t work with the child because his behavior is so out there. I’m sure he has ADHD.” Because of your role in the school, you are able to make observations and gather more information from parents and teachers that answer questions such as: Is this child’s behavior appropriate for his age? Does her behavior seem different from other students in her class? What is school like for this student? Through these processes, school helpers engage in a process of “figuring out” whether the presenting concern is accurate and complete.
• As an “educator,” a helper considers the strategies that will best help a student learn new thoughts and behaviors. That may mean that the helper teaches these new skills, but she will also encourage students to think for themselves. The professional helper will want to consider the best strategies for communicating new information. Most importantly, the helper as educator observes the student perform the new behaviors and provides feedback (as a consultant).

2. Describe the importance of developing a therapeutic alliance and how you plan on accomplishing this with your clients.

• Although the focus of cognitive-behavioral approaches is on thoughts and behaviors, this emphasis is not to the exclusion of the therapeutic relationship.
• Beck et al. (1979) noted that one of the most common errors in the therapy process was “slighting the therapeutic relationship”.
• The helper works to establish an empathetic and empowering relationship that encourages students to explore their own thoughts and feelings.
• Kendall and Southam-Gerow found that the therapeutic relationship was viewed as one of the most important components to children who had completed CBT. When a trusting, safe relationship exists, youth are more likely to attend sessions, to stay with the counseling until they have met their goals, and to experience better outcomes.
• School-based professionals must develop therapeutic relationships with their student clients even if they are using a very structured cognitive-behavioral intervention
• The therapeutic relationship is important to treatment outcomes, especially for young clients who may not have “chosen” counseling.
• School-based professionals must also consider the role of the social and family context in their delivery of cognitive behavioral interventions.

3. Discuss the structure of CBT sessions.

• Whether provided in an individual or group format, the structure of CBT sessions tend to follow a similar format. The session begins with a review of the previous week. Based on the issues that arise, the school-based helper and student client engage in goal setting and session planning. Much of the counseling session focuses on a collaborative form of learning. As such, the professional helper focuses on methods for involving children and helping them identify those areas that they would like to change in their lives.
• A variety of strategies are used during the session but might include teaching, problem-solving, modeling, and role play with feedback.
• With children, you’ll want to choose active, fun tasks that are appealing and developmentally appropriate. Treatment components may be introduced using workbooks, stories, puppets, drawings, and other types of hands-on activities.
• At the end of the session, homework is often assigned to help the student apply the new skill or strategy.
• Increasingly, there are manualized forms of treatment that provide a step-by-step guide for selecting and implementing strategies to address a specific concern (e.g., anxiety, depression). Kendall (2006) cautioned that helpers remain flexible and not overlook the relationship when using a manual-guided intervention. It is also important to keep in mind that just because a therapeutic approach is evidence-based and standardized, does not mean it will necessarily be effective for the specific student with whom you are working. You may find that you need to make slight modifications in the treatment from what is presented in the manual. In fact, flexibility in using manualized treatment is important to helpers.
• There is not a “manual” for all the various issues and concerns that you will encounter in the school. Therefore, you will want to be familiar with the various techniques that are available within a CBT model. Together with your student clients, you will decide on and practice those strategies that you believe will work best to help them reach their specific goals.

4. Discuss the role of homework in CBT and give examples of a few homework assignments you may assign.

• At the end of a session, students are typically assigned some type of homework to practice their new thinking or behaviors in the broader school environment.
• School-based helpers may assign homework with the goal of encouraging student clients to make observations about their thoughts and behaviors or apply their learning to “real-life” situations.
• This homework might take the form of journaling (structured to note situations, thoughts, feelings, and alternative ways of thinking), practicing positive self-statements, or increasing one’s exposure to feared situations.
• Homework assignments might be limited to 15 or 30 minutes at first and then increased as the student client becomes more engaged in the change process.